What are the responsibilities and job description for the RN UR position at South Central Health System?
GENERAL FUNCTION:
This position is responsible for providing utilization review duties and relating effectively with interdepartmental and intradepartmental personnel, medical staff, patients, patients’ families, and outside agencies.
JOB DUTIES:
- Thoroughly review assigned cases adhering to procedure for each specific review type within designated time frame
- Communicate clearly and effectively in all situations and respond to requests in a timely manner
- Plan and prioritize daily work to maximize productivity and efficiently manage time
- Establish and maintain effective working relationships with co-workers, supervisors, administration, and the general public
- Attend training and develop relevant knowledge skills
- Adhere to health and safety policy of the hospital
- Comply with HIPAA/confidentiality guidelines
- Operate a variety of standard office machines and adhere to procedures relating to the proper use and care of office equipment
MINIMUM QUALIFICATIONS:
RN, LPN, RHIT/RHIA trained or eligible, or non-credentialed person with previous Utilization Review experience and a basic understanding of ICD-10 coding and Interqual criteria.
CONTACTS:
Physicians, nurses, other hospital departments, clinics, and pre-cert companies.
DECISION MAKING:
- Distinguishing between pertinent and non-pertinent clinical information.
- Determining when additional information may need to be requested by physician.
- Prioritizing daily work to maximize productivity.
- Deciding when follow up is necessary on incomplete authorizations.
PHYSICAL REQUIREMENTS:
Walking, lifting, pushing/pulling buggies, operating office equipment.
RESPONSIBLE FOR:
Proper use and care of general office equipment including computer, telephone, copier, printer, fax machine, and shred receptacles.
